Children's Home run by Pathway Care Solutions Ltd 04004053 in Nottingham

Unique reference number SC029504 Inspector Philip Cass Type of inspection Full Provision subtype Children's home

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Registered person Pathway Care Solutions Ltd Registered person address 14 Regent Street NOTTINGHAM NG1 5BQ

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Responsible individual Ameer Rehman Registered manager Katherine Elaine Sydenham Date of last inspection 20/03/2014 2 of 9 Inspection date 03/12/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness good

Outcomes for children and young people adequate Quality of care good Keeping children and young people safe good Leadership and management good

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Overall effectiveness

The home has an established reputation for providing a high standard of care. This has previously yielded good and exceptional outcomes. The stable and consistent staff team continue to deliver good quality care. Managers and staff are able to demonstrate that meaningful progress is being made by all young people. However, despite the best efforts of staff, some current residents are not doing as well as they had anticipated at the point of admission.

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Overall effectiveness

Managers are aware of the social, family, health and interpersonal issues that prevent good quality care from yielding consistently good outcomes. They have realistic plans in place to address these issues. Consequently, they are confident that young people will make stronger progress in the future. Management arrangements are effective. Staff feel very well supported by the Registered Manager.

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Overall effectiveness

Young people are safe in the home. Where they engage in risk taking behaviour, staff take pro-active measures to minimise potential harm. Safeguarding arrangements minimise the potential for abusive practice to develop. Strong health and safety arrangements mean that the risk of accidental injury is low.

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Overall effectiveness

The home is asked to more actively contribute to pathway planning for young people. 3 of 9

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Information about this children’s home

This is a home that provides for young people with emotional and/or behavioural difficulties. It is registered to accommodate up to four children and young people. It is run by a private company.

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Inspection date Inspection type Inspection judgement

20/03/2014 Interim good progress 20/11/2013 Full outstanding 11/03/2013 Interim good progress 01/08/2012 Full good

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 ensure that the home contributes to the development of the pathway plan for “eligible” care leavers and works collaboratively with the young person’s social worker or personal advisor in implementing the plan (NMS 12.2) 4 of 9

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Outcomes for children and young people adequate

Some young people learn to take responsibility for their own health. They develop habits that make them fitter, more self-confident, and emotionally resilient. By providing young people with unconditional positive regard, staff help them to grow in self-esteem and feel valued. This approach supports young people to manage the impact of previous negative life experience. However, other young people do not make progress towards a healthy lifestyle. Risk taking behaviours, such as drug and alcohol use, are not reducing for all young people. Multi-agency strategies are in place to address these issues. Social workers confirm that the factors which currently prevent young people achieving strong outcomes are generally beyond the control of the home. They say that staff, ‘try all they can’ to help young people achieve good health outcomes. Local police are very supportive of the homes efforts to reduce unsafe behaviours. They say that the underlying causes of risk taking and unhealthy

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Outcomes for children and young people adequate

behaviours are those that, ‘the home has the least control over’.

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Outcomes for children and young people adequate

Educational outcomes are also mixed. Some young people make great progress in both attendance and achievement. They gain qualifications, or are on course to gain qualifications, that enable them to move into further education or gain employment. In some cases, young people with a significant history of school failure make real progress in overcoming barriers to achievement. They learn to value education and achieve success. However, other young people do not make the same progress. Lower than anticipated levels of attendance mean that some young people do not achieve to their full potential. Despite the determined efforts of staff, some older residents are not regularly engaged in educational activity or vocational training. Their current levels of educational engagement are unlikely to lead to realistic employment opportunities.

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Outcomes for children and young people adequate

Some planned moves from the home take place in a structured and supportive manner. This ensures that the views of young people are prioritised. It also means that information is shared carefully with future placements so that needs, vulnerabilities and risks are well understood. Other young people experience less well organised transitions. The home is able to demonstrate that young people acquire practical life skills to prepare them for adult life. However, it does not robustly advocate for young people whose pathway plans are not clear. In some cases the home has not actively contributed to the development of transition plans. As a result, some older young people are not confident about their readiness for independence and adulthood.

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Quality of care good

5 of 9 Young people say that the home is a ‘good’ place to live. Staff interact with young people in an empathetic and sensitive manner. They are good role models because they are consistently courteous and respectful in their interactions. Their nurturing approach means that young people often engage with them in a warm and affectionate manner. Although young people are occasionally disrespectful or antagonistic towards their carers, they generally hold them in high regard and value their support and care. Staff show a high level of commitment to the young people. Their resilience and dedication enables young people to build trusting relationships.

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Quality of care good

Care planning is of a good standard. This means that the complex needs of each young person are identified promptly and well understood by all staff. The views of young people are actively sought through formal and informal consultation processes. As a result, young people have influence over their care plans. Effective consultation also ensures that young people have an active voice in the running of the home. Staff are highly committed to principles of equality and diversity. Needs that stem from the culture, religion or background of young people are positively addressed in care plans.

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Quality of care good

Young people know how to make a complaint and are confident to raise concerns about the quality of care they receive. Staff are careful to ensure that young people also have access to a range of external safeguarding, advocacy, and regulatory bodies should they be unhappy about the way their complaint is dealt with. Young people are always informed of the outcome of their complaint. This means that they understand that their views are listened to and taken seriously.

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Quality of care good

The home offers a range of interesting and constructive activities. Young people report that they enjoy these activities, and that they enjoy their leisure time with staff. By taking part in positive activity, young people begin to develop interests and skills that improve their self-esteem. Young people speak very positively about their recent holiday to Spain. They say it was ‘great because we were able to just relax’. Opportunities to travel enable young people to experience different cultures and have experiences similar to their peers in the community.

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Quality of care good

Effective multi-agency arrangements mean that a comprehensive range of health services are available to young people in the community. This ensures that they are provided with good quality health care. Although young people express frustration with some decisions made by mental health professionals, they are provided with appropriate treatment and support. Medication administration systems are safe and effective.

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Keeping children and young people safe good

6 of 9 Young people are safe, and say that they feel safe, in the home. Staffing ratios reflect identified risks and are appropriate to minimise the impact of violent and damaging behaviours. A recent increase in the scale and frequency of highly challenging behaviour has resulted in additional resources being allocated to the home. At times, senior managers have attended to support the staff team. Despite current challenges, staff are confident in their behaviour management skills. They say that, ‘we have been here before, we know what we are doing, and we are on top of it’. Good working relationships with local police means that emergency situations are managed well, with minimal disruption to young people. There are isolated incidents where the support of police is required to manage violent or damaging behaviours. Because staff communicate well in these situations, safety and order is achieved without unnecessarily criminalising young people.

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Keeping children and young people safe good

Clear recording of disciplinary measures enables managers to monitor effectively. This reduces the risk of abusive practice developing. Young people report that there is bullying but this is quickly identified and dealt with. They are provided with good information about bullying and its potential impact on others. This helps them to understand that they should not bully others. It also means that they know how to respond, and who to talk to, if they are the victim of bullying. Because bullying is well managed, young people feel safe in the home.

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Keeping children and young people safe good

Young people are often admitted to the home with entrenched patterns of running away from carers and placing themselves at considerable risk while missing. When young people settle into the home they stop running away. This means that they are considerably safer. The risk of abuse is also significantly reduced because staff and managers have a comprehensive understanding of safeguarding procedures. Staff are committed to working in line with these procedures. Effective monitoring, reporting, training and inter-agency systems minimise the likelihood of harm to young people in the home. The home carefully follows safe recruitment procedures. These include criminal record checks and telephone verification of references. Consequently, the risk of the home appointing inappropriate adults to work with the young people is reduced.

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Keeping children and young people safe good

Staff are skilled in the management of self-harm. They confidently and assertively support young people who present a risk to themselves. They also demonstrate a good understanding of the individual factors that trigger self-injurious episodes. Staff carefully monitor young people in crisis and make extra checks when changes in presentation or demeanour are observed. This means that, over time, young people become safer. Social workers speak very positively about the home’s pro-active approach to managing self-injurious behaviours.

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Keeping children and young people safe good

Environmental risk assessments are comprehensive and frequently updated in response to identified risk. Staff are aware of the home’s risk assessments and, because they adhere to them fully, the risk of accident and injury is minimised. Fire safety systems are effective and appropriately monitored by the manager and senior staff. Periodic testing of gas and electrical systems also reduces the likelihood of 7 of 9 accidental injury.

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Leadership and management good

The Registered Manager has been in post for over 10 years. She is suitably qualified and experienced to undertake the role. Staff receive regular supervision that they find helpful and supportive. Supervision is used effectively, alongside performance management processes, to improve work practice and set high expectations of staff. Because managers ensure that they are available and accessible, staff are able to seek advice and guidance promptly. On call arrangements are effective and mean that an experienced manager is available to support staff at all times.

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Leadership and management good

One recommendation was set at the previous inspection of the home. This has been fully addressed. As a result, external monitoring of the home is more effective in generating improvement. Improvement is also promoted by robust internal quality assurance processes. Managers and directors of the organisation are good at identifying weaknesses and potential shortfalls. Actions generated through quality assurance processes are positively addressed by the home and result in improved standards of care. Additional improvement objectives are set out in the home’s development plan. The plan has driven improvements in activity planning, the appearance of the home and multi-agency working. Performance management systems are effective in providing challenge where work practice does not reach the highest standards expected by the home.

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Leadership and management good

Managers are fully aware of the challenges and barriers that currently prevent young people from achieving to their full potential. Where complex family, health, or social issues mean that good quality care is not translated into good outcomes, staff work with a range of external services to understand and address the issues. Multi- agency working arrangements are strong. Social workers, health professionals and school staff all note the competence and commitment of the Registered Manager. A teacher at a local school reports that, ‘the Manager is always available at the other end of the phone. We work as a team’.

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Leadership and management good

Training is of a high standard. As well as essential training in areas such as safeguarding, restraint, first aid, and food hygiene, staff undertake specific training that is tailored to individual needs of young people. This includes training in behaviour management techniques. New employees are provided with a comprehensive induction that supports them to develop good quality care practice. Existing staff have attained or are completing a level 3 qualification in care. This means that they are suitably qualified for their role.

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Leadership and management good

When concerns are raised about the service by external professionals, the home acts 8 of 9 constructively to achieve a positive resolution. The home views complaints positively as an opportunity to improve the service. This means that lessons are learned effectively from any shortfalls identified. Where social workers feel that an alternative placement would be more suitable for particular young people, the home is pro- active in facilitating smooth transitions by sharing information, strategies and guidance with the new carers. Website: www.ofsted.gov.uk

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Leadership and management good

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information about this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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Information about this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the framework of inspection for children's homes.

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